How to recover after C-section?
This article will follow on from a previous blog post which explored common symptoms after caesarean birth. The main symptoms discussed in the previous article include:
Visual changes: Hypertrophic scars (raised, red and bumpy), keloid scars (thickened, wider. More uncomfortable), as well as scars that are tight and appear 'stuck' and drawn in.
Sensory changes: Altered sensation and numbness, tenderness, itching.
Physical changes: Pulling and movement restrictions.
What’s the next step? There are many simple interventions that you can try at home and a variety of treatment options to be explored with a scar specialist, all of which can be extremely beneficial. It’s important to know when you’re ready to start, so we’ll begin by exploring different options at different stages of healing. There are many simple interventions that you can try at home and a variety of treatment options to be explored with a scar specialist, all of which can be extremely beneficial. It’s important to know when you’re ready to start, so we’ll begin by exploring different options at different stages of healing.
Image source: Unsplash
First 8 weeks
Rest, recuperation and prioritising wound healing are the main things you should be focussing on after caesarean birth. If you can, allow or ask others to do as much as they are able to help you during this time. In the initial stages of healing, keeping your wound clean and watching out for signs of infection is the best care you can give your body at this time. However, there are a few things you might like to slowly introduce as you feel able, and are keen to start engaging with your body again.
Deep breathing - aside from this generally promoting relaxation and regulating your nervous system, breathing well and allowing your ribs to expand as you inhale is the foundation of regaining your core function postnatally. It is also a really effective way of getting some very gentle movement through your scar without placing it under undue stress or load.
Touching your tummy away from your scar - this can be really difficult at first, but is a great first step in engaging with your scar and a great way to connect with your tummy again.
Stay hydrated - this will help with your scar healing, but also help with regular bowel movements and keep your stool soft. This is important as softer stools that pass more easily will put less pressure on your scar.
Gentle scar support - using a clean towel to apply gentle pressure over your tummy when moving, coughing, sitting in the car (to name a few examples) can feel supportive.
8 weeks and beyond
There are several things you can do to help improve the visual and physical symptoms of problematic scars once the initial healing phase is complete. The main two approaches that are often used side by side are the use of products in the forms of creams and gels, and massage techniques performed on yourself or by a qualified practitioner.
Products
Photo of a C-section wound with steri-strips and a tethered scar
Once your scar has fully healed, the next most important thing is to nourish and protect the skin barrier and your new scar. Scar tissue is not quite as robust as the skin elsewhere on your body, and it loses a lot of moisture through this thinner barrier. That’s why at this stage hydration is key in the form of creams and lotions. Whilst most moisturisers will help, using a product that also contains ingredients that form a protective barrier and penetrate down into the deeper layers can really help to lock this moisture in. This is important because it can help prevent excess lay down of collagen which presents in the form of raised and bumpy scars.
Are there any particular products that are advised?
A product that is widely used in scar care and can be used as soon as your scar is fully healed is silicone. This is the gold standard in scar care, and is widely used to help prevent scars from becoming red and raised, and is also used in the treatment of scars that have already become red and raised. Silicone forms a strong protective barrier over the scar, trapping moisture and allowing the natural healing process to take place. It can be used in the form a gel or in silicone strips. The strips can be particularly useful over caesarean scars as they can feel like an extra layer of protection over a vulnerable area, and the silicone won’t rub off in the way that creams can. Some silicone strips are also quite thick which provides a compressive element, the other gold standard in scar care.
Massage
Scar massage is a great way to start engaging with your scar and tummy and reconnecting to your body. This can help physical symptoms, but for many women it can also start to help them accept the changes that have happened to their body, oftentimes from an unexpected or unplanned surgery.
From a physical perspective, one of the main symptoms most women experience for varying lengths of time is numbness or altered sensation across their lower tummy and scar. This is as a result of nerves being disrupted during the caesarean and can feel quite strange. Light and gentle stroking techniques can help stimulate superficial nerve endings, and is a great thing to start with at home. This can take place quite far away from your scar until you feel more comfortable to move closer when you’re ready.
Many women also report feelings of tension, pulling, and movement restrictions. The scar itself and a lack of movement and mobility through this part of your body during early healing can contribute to this. Slightly deeper and more focussed techniques can be more helpful to resolve these symptoms, aiming to mobilise the scar site itself (not necessarily with direct contact to the scar at first), and the surrounding tissue. It can be really beneficial at this stage to also address any tension in the hips, thighs, lower back, and elsewhere in the abdomen which could be contributing. This could be using generalised massage and stretching techniques.
This tension and tightness can also be one of the contributing factors to the ‘overhang’, or ‘shelf’ as some women describe it. Visually, this appears as a section of tissue that hangs over the scar line and sometimes protrudes more than the rest of the abdomen. Often also at play is scar tissue that has formed, and is drawing in towards the midline of the body, thus creating the ‘shelf’. Deeper techniques aimed at mobilising the scar tissue can be effective here, as well as the use of negative pressure devices that suck and lift the tissue away from the midline, attempting to create more movement. In combination with other techniques, this can also allow lymph fluid to move more easily and improve congestion, thereby restoring a more ‘natural profile’.
Image of a red C-section scar
The technique most appropriate for you will depend on a few factors such as the age of your scar, your symptoms and your goals. If you can, it’s best to consult with a scar practitioner who can directly treat your scar but also offer you tailored home care advice so you can be sure you’re optimising your recovery at home.
Author: Amy Poole (Scar Specialist, Pilates Teacher and Sports Rehabilitator)